The VA Rural Veterans Outreach Toolkit

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Version 2.0 VA U.S. Department of Veterans Affairs Veterans Health Administration Office of Rural Health “A collaborative approach with communities for serving Rural Veterans” The Rural Veteran Outreach Toolkit

Transcript of The VA Rural Veterans Outreach Toolkit

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Version 2.0

VA U.S. Department of Veterans Affairs

Veterans Health AdministrationOffice of Rural Health

“A collaborative approach with communities for serving Rural Veterans”

The Rural Veteran

Outreach Toolkit

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“VA is proud to partner with the community organizations that share our dedication to serving those who served this Nation.”

Erik Shinseki, Secretary Department of Veteran Affairs (October 5, 2011)

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VHA Office

of Rural Health

VHA Office of Rural Health

Authors

Nancy Dailey, MSN, RN Deputy Director, Veterans Rural Health Resource Center-Western RegionBret Hicken, PhD Health Scientist, Veterans Rural Health Resource Center-Western RegionChris Turner Program Specialist, Veterans Rural Health Resource Center-Western Region

For more information about this toolkit email: [email protected]

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Forward

Forward

Welcome to the Rural Veteran Outreach (RVO) Toolkit, Version 2.0. Since the development of the original RVO Toolkit two years ago, we have made several modifications, as well as additions to this resource based on the lessons learned in many communities in which we have implemented the process. Our VA and community partners have been key to the continuous quality improvement process we strive for in making this toolkit a valuable resource in reaching our rural Veterans.The new features of this toolkit include:• Testimonials from VA staff, community leaders,

service partners and Veterans who have experienced the successes of Rural Veteran Outreach

• A section covering considerations for developing outreach that is culturally sensitive.

• Additional web-based resourcesAs you use this toolkit, we hope that you find the enhancements relevant to your efforts to reach rural Veterans. Comments on lessons learned and feedback on improvements to this document are encouraged and welcomed. We would like to include those elements that have broad applicability to the next iteration of the RVO Toolkit. Please submit your comments to [email protected].

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IntroductionWhile many are aware of Department of Veterans Affairs (VA) healthcare in urban areas, it is less known that 35 percent of all Veterans live in rural areas and have limited access to healthcare. Often, the lack of VA resources in rural areas means Veterans must travel great distances to access care or see a benefits specialist. Despite VA’s progress in opening outreach clinics in rural communities, there are numerous areas in the country where Veterans continue to be underserved. Only about half of Veterans eligible for VA healthcare benefits have enrolled.VA’s Strategic Plan recognizes the challenge rural Veterans face in accessing their benefits and emphasizes partnership between VA and community agencies as a means of improving access for all Veterans. In Fiscal Year 2011, the Office of Rural Health and the Veterans Rural Health Resource Center – Western Region developed the Rural Veterans Outreach (RVO) Program, built upon lessons learned in the successful Tribal Veterans Representative program in VISN 19. This toolkit contains the lessons learned from outreach activities in many rural communities throughout the Western US. Without the support of our community partners, many of whom are Veterans, this endeavor would have been more difficult and we are indebted to them for their assistance.This toolkit was developed to assist VA personnel in collaborating with community partners to reach rural Veterans through education and outreach. Using this toolkit will help:• Build a relationship between VA and rural communities.• Teach rural communities about benefits and services available to Veterans.• Connect VA programs with community partners to assist Veterans.• Improve outreach to Veterans living in rural areas.• Help rural Veterans access local community resources.• Increase Veteran enrollment in VA programs and services.

Recognizing that there are many models of outreach within the VA organization, we welcome and encourage constructive feedback on the contents of this toolkit. We wish to continuously improve our reach to rural Veterans through a sharing of ideas, processes, and best practices.

Veterans Rural Health Resource Center – Western Region Team

Introduction

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Acknowledgem

ents

AcknowledgementsThe Veteran Rural Health Resource Center – Western Region and the VHA Office of Rural Health wish to express gratitude and acknowledge the efforts of our community and VA partners in the developing and implementating the Toolkit materials. We value the relationships we have built and appreciate the enthusiasm, dedication and commitment to continue this important work for years to come.

Alaska VA Health Care System Central Texas Veterans Health Care

Kodiak, Alaska Brownwood, Texas

Sitka, Alaska West Texas VA Health Care System

VA Loma Linda Health Care System Abilene, Texas

Blythe, California Alpine, Texas

San Francisco VA Medical Center San Angelo, Texas

Eureka, California VA Sierra Nevada Health Care System

VA Central California Health Care System Silver Spring, Nevada

Oakhurst, California South Texas Veterans Health Care System

Tulare, California Del Rio, Texas

Mann-Grandstaff VA Medical Center (Spokane, WA) Uvalde, Texas

Moses Lake, Washington VA Salt Lake City Health Care System

New Mexico VA Health Care System Price, Utah

Roswell, New Mexico

Other partners:

W.J. “Buck” Richardson, VISN 19 Minority Affairs Coordinator

Mary Beth Skupien, PhD, RN, Past Director, VHA Office of Rural Health

Secretary of the U.S. Department of Veterans Affairs’ Rural Health Advisory Committee

Table of Contents

Why Community Partnerships? ....................................................................................................1The Rural Veterans Outreach Program ..........................................................................................3Selecting a Community .................................................................................................................4Understanding the Community ....................................................................................................5Planning a Community Information and Referral Workshop ........................................................8Planning a Community Outreach Event .....................................................................................10Sustaining the Partnership ...........................................................................................................11References ...................................................................................................................................12Appendices .............................................................................................................................13-20

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AcknowledgementsThe Veteran Rural Health Resource Center – Western Region and the VHA Office of Rural Health wish to express gratitude and acknowledge the efforts of our community and VA partners in the developing and implementating the Toolkit materials. We value the relationships we have built and appreciate the enthusiasm, dedication and commitment to continue this important work for years to come.

Alaska VA Health Care System Central Texas Veterans Health Care

Kodiak, Alaska Brownwood, Texas

Sitka, Alaska West Texas VA Health Care System

VA Loma Linda Health Care System Abilene, Texas

Blythe, California Alpine, Texas

San Francisco VA Medical Center San Angelo, Texas

Eureka, California VA Sierra Nevada Health Care System

VA Central California Health Care System Silver Spring, Nevada

Oakhurst, California South Texas Veterans Health Care System

Tulare, California Del Rio, Texas

Mann-Grandstaff VA Medical Center (Spokane, WA) Uvalde, Texas

Moses Lake, Washington VA Salt Lake City Health Care System

New Mexico VA Health Care System Price, Utah

Roswell, New Mexico

Other partners:

W.J. “Buck” Richardson, VISN 19 Minority Affairs Coordinator

Mary Beth Skupien, PhD, RN, Past Director, VHA Office of Rural Health

Secretary of the U.S. Department of Veterans Affairs’ Rural Health Advisory Committee

Table of Contents

Why Community Partnerships? ....................................................................................................1The Rural Veterans Outreach Program ..........................................................................................3Selecting a Community .................................................................................................................4Understanding the Community ....................................................................................................5Planning a Community Information and Referral Workshop ........................................................8Planning a Community Outreach Event .....................................................................................10Sustaining the Partnership ...........................................................................................................11References ...................................................................................................................................12Appendices .............................................................................................................................13-20

Table of Contents

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Why Community Partnerships?

Community partnerships are important because VA does not have a physical presence in every rural community. Working with enthusiastic partners such as aging programs, churches, and other agencies helps VA to reach more Veterans in rural areas. These agencies are trusted members of the community and are experts on local customs and needs. They care about their community and about helping Veterans and their families.

Advantages and ChallengesA partnership between VA and communities offers many potential advantages:• Pooling resources such as budget, personnel, and facilities.• Developing enthusiasm and commitment within the community.• Creating stronger VA presence in community.• Extending the reach of VA when VA resources are not present.• Local expertise to help VA understand local values, customs, needs, and barriers that may

affect outreach.• Identifying trusted community partners who can connect VA services to rural Veterans.• Creating good will between VA and communities can pave the way for future collaboration

and innovation.• Eliminating or reducing redundancy of efforts.• Creating additional entry points for Veterans to receive accurate information and coordinated

efforts to accessing benefits and services.Working within rural communities may have challenges:• Previous experience working with the federal government may make communities wary of

partnering with VA. • Concern about financial or time expectations of a partnership.• Belief that VA is not concerned about needs of Veterans in remote communities.• Frustration with a complex VA system.• Lack of a formal structure within the community to support Veteran-focused activities.

Change - Why Is It Difficult?To some, the RVO aims represent a different approach to outreach that may seem threatening and can derail progress. Understanding the reasons for resisting change helps an organization to change. Change is difficult for a variety of reasons:9

• It’s unknown – One of life’s greatest fears is the unknown. It causes us to resist those things for which we cannot easily see a well-known outcome.

• It’s challenging – Change forces us from our “comfort zone” and the degree of acceptance of change varies from individual to individual.

• It’s uncertain – When we change, we are often introducing untested waters. We prefer certainty.• It’s unpopular – The resistance to change is universal. Change invites animosity and tension.

Change is more likely to occur under certain conditions:10

• When enthusiasm or progress towards goals is diminishing with “the way we’ve always done things”.• When you have a plan that is well thought out and purposeful.• When the change will result in greater use of existing resources.

Why Com

munity Partnerships?

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Why Com

munity Partnerships?

• When it is clear a change will be needed to meet customers’ expectations and performance measures.Several strategies can help smooth the change process:• Meet with your partners, preferably in person, to clarify the desired outcomes and goals of a

partnership. Identify potential organizational resources needed to successfully achieve mutual goals.• Familiarize yourself with the cultural differences among all the partners. This includes

corporate cultures that may affect how the organization perceives the partnership. Embrace and understand diversity.

• Develop a plan that identifies milestones and roles so that each partner knows what to expect from the process and from each other.

• Remind people frequently of common goals, the main one being to assist Veterans.• Celebrate successes no matter how big or small!

Key VA Stakeholders A variety of potential partners exist within VA and this will vary by location. Securing support from local VA leadership early in the process ensures a commitment of resources for successful outreach to communities. A local VA champion should spearhead outreach activities and represent VA in a rural community. Some VA offices and programs have, as part of their mission, to provide education and outreach:• Veterans Health Administration (VHA)

– Rural Health Coordinators – Public Affairs Officers/Outreach Coordinators – OEF/OIF/OND Program Managers – Telehealth Coordinators – My HealtheVet Coordinators – Homeless Veterans Program Managers – Women Veterans Program Managers – Patient Advocates – Enrollment Specialists – Office of Rural Health and Veterans Rural Health Resource Centers – VISN Planner

• Veterans Benefits Administration (VBA) – Outreach Coordinators

• National Cemetery Administration (NCA) – Administrative Officers – Public Affairs Officers

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The Rural Veterans Outreach Program

The RVO program expands on traditional Veterans outreach by focusing on:• Understanding local Veterans’ needs by learning

about the community, its resources and challenges.• Developing an enduring VA presence in the

community through existing non-VA agencies.• Implementing outreach activities that promote

partnership between VA and the community to help rural Veterans.

This toolkit describes several steps the RVO program uses to promote partnership between VA and communities:

Step 1. Selecting a CommunityStep 2. Understanding the CommunityStep 3. Planning a Community Information and

Referral WorkshopStep 4. Planning an Outreach EventStep 5. Sustaining the Partnership

Selecting a Community

Understanding the Community

Plan a CommunityInformation and

Referral Workshop

Plan anOutreach Event

Sustaining the Partnership

“I came in here today angry, but I’m leaving with a smile.”Vietnam Veteran attending an outreach event

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Selecting a Community

Rural communities where success is most likely have several things in common: • Communities where a high percentage of Veterans are not

enrolled in the VHA.• Areas with established Veteran service organizations or coalitions. • Areas with organized community advocacy groups that are well-

connected with other community agencies.• Areas where VA already has some presence in the community.• Areas where VA facilities are underutilized.• Communities where partners have already approached the VA

about collaboration.

Selecting a Community

Understanding the Community

Plan a CommunityInformation and

Referral Workshop

Plan anOutreach Event

Sustaining the Partnership

In one community, VA partnered

with a non-profit community health coalition that had

created a compact to serve Veterans and their dependents.

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Understanding the Community

The initial aim in approaching a community is to listen and learn. Rather than offer a “program” to help Veterans in a community, focus on understanding community needs, values and culture from their perspective. Conducting advance research about the community demonstrates interest in beginning to work together. Your research may identify individuals and organizations that are concerned about Veterans and may want to participate in partnership activities. Your understanding of the community will change as the partnership develops over time. New information may require adjustments to your plans, but will ultimately result in better outreach because you will have adapted to local needs.Keep in mind that communication flows differently in rural communities than it does in large organizations like the VA. The VA mode of communication is typically formal. It relies on chain of command, policies, and other “official” guidance for spreading information. Individual decision-making is usually limited without approvals from supervisors at multiple levels. On the other hand, rural communities typically communicate more informally. Information is spread by word-of-mouth—often very rapidly—and there are few if any levels of leadership that must grant approval for action to occur. This contrast in communication styles can sometimes lead to frustration because the formal VA process can slow things down. Some community members may perceive slow action as disinterest from the VA. As partnerships are beginning to form, be open about the policies and approval process required by your facility. Explaining these factors early will help avoid confusion and frustration later on.The Internet can be a helpful source for information on local:• History and demographics• Economy and infrastructure• Governance• Veteran data• Local, county and state organizations that serve the community • Agencies that serve Veterans

Several websites offer helpful information about communities (Keep in mind that some rural agencies do not have websites):• www.usacitiesonline.com• www.hometownlocator.com• http://www.irs.gov/uac/SOI-Tax-Stats-Exempt-Organizations-Business-Master-File-Extract-

(EO-BMF) (searches for non-profit organizations by city)• www.census.gov• Local Chamber of Commerce websites

Selecting a Community

Understanding the Community

Plan a CommunityInformation and

Referral Workshop

Plan anOutreach Event

Sustaining the

Partnership

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Enthusiastic Partners - Who are they?Successful partnerships include all stakeholders who can pool resources and use their expertise to meet shared goals. The partners available in each community will vary but the following agencies are present in most states:• State and local Veteran groups. These include state and county

Veterans offices and Veterans Service Organizations (VSO) like the American Legion or Wounded Warriors. Many of these organizations offer trained service officers to help Veterans apply for benefits and services.

• State Offices of Rural Health. These offices collect information about rural issues and coordinate rural health resources and activities statewide.

• Aging services. Many rural Veterans may already be receiving help from local aging services, which are offered through most counties in the US, though in rural areas, a single office may cover multiple counties.

Other important community groups may include:• Community service organizations• Local Veteran service officers• Employment services• State and county health departments• Other federal, state or local government and social service agencies• Non-profit organizations• Academic institutions• Faith-based organizations• Public safety• Healthcare providers• Chamber of Commerce and other local business organizations• Media• Libraries• Military groups (e.g., National Guard and Reserves units)• State Offices of Veterans Affairs

Information about the

community can be

compiled into a resource

book for VA staff and

community members.

Understanding the Com

munity

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Cultural ConsiderationsIt is common for some people to assume that strategies to help Veterans in one rural community will work everywhere else. However, great diversity exists within rural communities; problems, values and needs will vary. Developing a partnership in rural areas requires attention to and respect for these local differences. This can be especially important with respect to local ethnic, religious and regional cultures. In some rural areas it may be necessary to adapt activities to accommodate local cultural customs. This flexibility conveys respect and fosters trust as the partnership develops. Before beginning outreach into a community, take time to consult with partners and others familiar with the area about local customs. Educate yourself about beliefs, traditions and social norms that may affect how you interact with community partners and Veterans in the area. This preparation can avoid potential offenses down the road. Some online resources may be helpful in understanding certain cultural groups: VA Center for Minority Veteranshttp://www.va.gov/centerforminorityveterans/

The Office of Minority Affairs-US Department of Health and Human Serviceshttp://minorityhealth.hhs.gov/templates/browse.aspx?lvl=1&lvlID=3

Cultural Competence and Limited English Proficiencyhttp://www.raconline.org/topics/culture/

Understanding American Indian and Alaskan Native Cultures http://store.samhsa.gov/shin/content//SMA08-4354/SMA08-4354.pdf

Working with Hispanics ftp://ftp-fc.sc.egov.usda.gov/IA/about/WorkingwithHispanics.pdf

Cultural Awareness to Help While Serving Native Veteranshttp://www.ruralhealth.va.gov/webinars/cultural-awareness.asp

Be aware that in some communities,

cultural events/practices occur at certain times

of year.

For example, in some

American Indian communities,

the last part of June through July (i.e., Sundance)

might be difficult to

plan events due to cultural

practices.

Understanding the Com

munity

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Planning a Community Information and

Referral WorkshopIn our experience, most communities want to know how to help Veterans enroll in and obtain their VA benefits. A community information and referral workshop, held locally, is one way to address this need. Ideally, the workshop accomplishes three goals:• Educates the community about VA benefits and services and how to help Veterans obtain them.• Connects community groups with VA, state and local Veteran resources that can help meet

Veterans’ needs.• Facilitates networking among VA and the community to identify opportunities for collaboration.

Ultimately, the workshop opens dialog between VA and the community and creates opportunities for future partnership to address Veterans’ needs through collaboration.

Planning a Successful Community Information and Referral WorkshopThe workshop targets community agencies that may already encounter Veterans as part of their ongoing scope of work. By engaging these groups, the VA can develop a broader resource network of advocates for rural Veterans and a pool of potential partners addressing Veterans’ needs. Send invitations to all organizations such as those listed in the Enthusiastic Partners section of this toolkit. Remember, the “community” may be a much larger geographic area than the town where the workshop is being held. The “catchment” in many rural areas often includes multiple counties so agencies from all these counties should be invited to attend.The workshop provides an overview of VA services and benefits. The aim is not to train benefits specialists, only to provide attendees with a basic understanding of the benefits available to Veterans, the process for obtaining them and contact information for local people who can help answer detailed questions about benefits. This last point is crucial—local agencies need to know whom within VA they can contact for help with a Veterans’ needs. Invite local subject matter experts to present:• VHA, VBA, NCA and Vet Centers.• State Veterans benefits (State Office of Veterans Affairs).• Local VSOs and other organizations that serve Veterans.• Community groups that have Veteran programs.• State or county Veterans representatives can talk about state and federal benefits.

Invite a representative from each community group attending the workshop to give a short presentation on their agency and how they serve Veterans. This activity provides additional networking for local groups and helps educate VA about community resources for serving Veterans.

Selecting a Community

Understanding the Community

Plan a CommunityInformation and

Referral Workshop

Plan anOutreach Event

Sustaining the Partnership

“Meeting real people and getting valuable information. Placing a “face” on the VA…seeing folks who care about what they do and are passionate despite having to function within government bureaucracy.”

Comment from Community Workshop participant

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The other focus of the workshop is to engage the community and VA in a joint discussion of Veterans issues. We have found that including a group brainstorming session in each workshop (see our website for an example) reinforces to the community that VA is interested in hearing their thoughts about local Veterans issues and educates VA attendees about the how the community can be involved in addressing local Veterans’ needs.Strategies for a successful workshop:• Seek a local champion that can help identify the agencies to invite.• When an agency RSVPs, ask them for suggestions about other

agencies that may be interested in attending.• Inform presenters that they do not need to go into in-depth

details about eligibility criteria or forms.• Cover all VA programs so the community members are aware of

the programs that exist.• If known issues or problems are exposed early in the planning stages

use this time to address them or brainstorm possible solutions.• Provide phone numbers, emails, and contact names so community

groups know whom to contact with questions.• Request the presenters stay for the duration of the meeting to

answer questions and to network.• Presentations should leave plenty of time for questions and

discussion.• Allow plenty of time for informal networking.• See “Timeline and Suggestions for a Community Information and

Referral Workshop” in the appendix for additional information on planning a Workshop.

• Community partners commonly request information about military culture. See the appendix for resources to learn more.

At one workshop, a community

agency reported that they offered

grants to help Veterans with minor home

repair. The VA was able to

connect them with Veterans

in the area to obtain this

service.

“It has been my pleasure to take part in two of your workshops. I feel that the information communicated is invaluable. Not only did the seminars provide me with new contacts that serve the area Veterans, but they also gave me a better understanding of the VA system as a whole. My co-workers and I are now much more confident in directing our Veterans and their families to assistance that does not normally fall within our general area of service.”

NCA representative speaker at workshop

Planning a Comm

unity Information and Referral W

orkshop

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Planning a Community

Outreach EventThe main goals of the community outreach events are to:• Educate Veterans about their benefits.• Enroll Veterans in VHA programs, provide information on and

assist them in applying for other VA benefits.• Connect Veterans with other local resources.

These events are similar to a typical outreach event that VA would attend or sponsor, with one important exception: the planning committee of an RVO outreach event should include interested workshop attendees and local organizations. Ideally, the outreach event should be community-led as much as possible.

One purpose of the outreach is to strengthen the relationship between the community and the VA. Working together to plan this event increases trust, demonstrates mutual goodwill, and lays the groundwork for a future partnership to serve Veterans. Consider community traditions, calendars, and expertise so you can adapt the event to local resources and Veterans’ needs. The local chamber of commerce can usually provide a calendar of upcoming events. Your local partners can also help identify good dates and times for conducting outreach. Consider combining with an existing event based on the community leaders’ input, to maximize the exposure and marketing through existing resources.

Selecting a Community

Understanding the Community

Plan a CommunityInformation and

Referral Workshop

Plan anOutreach Event

Sustaining the Partnership

“I was impressed by the range of Veterans we met. I was fortunate enough to have met Veterans from various spectrums of service. They all thanked us for driving to see them and many even stopped by to show off their door prizes!”

VA Employee staffing an outreach event

Community members can help identify

local resources at free or

reduced cost.

“All the community partners and VA representatives were so positive and very supportive of the people who attended. I was impressed with the organization of the event and the willingness of VA employees to travel so far to reach out to the veterans.”

Community Partner

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Sustaining the Partnership

Ideally, the information and referral workshop, and Veteran outreach events will create a foundation for future collaboration between the VA and the community. Partnerships are sustained under the following conditions:• All participants share a common goal.• Partnership is mutually beneficial for all participants.• Communication is open, honest and inclusive.• Participants have mutual respect and trust.• All contribution levels and resources are accepted.

Collaboration on future activities to serve Veterans is an indicator of a sustaining partnership between the community and the VA. The form and focus of these activities depends on community and VA needs and will be different in each community. Examples of partnership activities that developed through RVO:• The MyHealtheVet coordinator and the local librarian developed a training module on

MyHealtheVet for use at the local/community library so Veterans would not have to drive to the medical center. The training was so successful that it was eventually offered at every library in the state.

• Two community clinics with the capacity for telehealth connected with the local VA telehealth coordinator to discuss expanding VA telehealth services to Veterans in this area.

• The local VA and one community developed a small outreach in association with a flu shot event for local Veterans to explain VA benefits and services, and provide enrollment assistance.

• The CBOC offered workspace to the county service officer to use in assisting Veterans with claims on a weekly basis.

• The local VA decided to hold a second workshop to train local medical providers on billing and contract procedures.

• The Department of Public Defender in one county connected with VA to begin setting up a Veterans Justice Court.

• A county court was able to refer Veterans with mental health problems to the local VA clinic for telemental health.

• The NCA coordinated a workshop for area funeral homes to educate about VA burial benefits.

This toolkit represents one approach to developing VA and community partnerships. We welcome feedback and ideas on other successful approaches. If you would like to give feedback, please email us. Our contact information is included at the front of this toolkit.

Thank you for the services you provide to those who served us: Our Nation’s Heroes, Our Veterans!

Selecting a Community

Understanding the Community

Plan a CommunityInformation and

Referral Workshop

Plan anOutreach Event

Sustaining the Partnership

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References1. Gallant MH, Beaulieu MC, Carnevale FA. Partnership: an analysis of the concept within the

nurse-client relationship. J Adv Nurs. Oct 2002;40(2):149-157.2. Roussos ST, Fawcett SB. A review of collaborative partnerships as a strategy for improving

community health. Annu Rev Public Health. 2000;21:369-402.3. McCormack D, Buck DM, McGraw B. A partnership model evolves from a living inventory of

engagement. Nurs Leadersh (Tor Ont). Dec 2010;23(4):61-80.4. Connor A, Rainer LP, Simcox JB, Thomisee K. Increasing the delivery of health care services to

migrant farm worker families through a community partnership model. Public Health Nurs. Jul-Aug 2007;24(4):355-360.

5. Scott C, Jaffee D, eds. Managing Organizational Change: A Practical Guide for Managers Menlo Park, CA: Crisp Publications, Inc.; 1989. Crisp MG, ed.

6. McNamara C. Organizational change and development. 2011; http://managementhelp.org/organizationalchange/index.htm. Accessed October 16, 2011.

7. Senge P. Stake holder involvement in change. 2011; http://www.change-management-toolbook.com/mod/book/view.php?id=74&chapterid=71. Accessed October 17, 2011.

8. National Organization of State Offices of Rural Health. Mission & Purpose. 2011; http://www.nosorh.org/about/mission.php. Accessed October 18, 2011.

9. Edmonson R. 4 Reasons Change Is Difficult 2009; http://www.ronedmondson.com/2009/11/4-reasons-change-is-difficult.html. Accessed October 24, 2011.

10. Edmonson R. Avoiding Change For Change’s Sake. 2009; http://www.ronedmondson.com/2009/08/avoiding-change-for-change-sake.html. Accessed October 24, 2011.

References

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AppendicesAdditional Rural Veteran Outreach resources can be found online at our website:

http://www.ruralhealth.va.gov/resource-centers/western/outreach-toolkit.asp• Sample community profile—document that summarizes research on the community.• Community Information and Referral Workshop Resources.

– Invitation Letter to Community Leaders for Community Benefits and Referral Workshop – Agenda for Community Information and Referral Workshop – “Save the Date” Postcard for Community Information and Referral Workshop – Presentation on Veterans Health Administration – Presentation on Veterans Benefits Administration and National Cemetery Administration – Evaluation for Community Information and Referral Workshop Event – Community Agency Information Card

• Sample Community Outreach Event Resources. – Public Service Announcement/Media Release – Flyer Announcing Outreach Event – Postcard to Veterans Announcing Outreach Event – Comment Card/Evaluation for Attendees (Community-Driven) – Vendor Registration Form

Appendices

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AppendicesOther VA Information Sources:

• www.va.gov • www.eBenefits.va.gov• The VISN’s strategic plan and needs assessment• ORH Zip Code Crosswalk

– This tool quickly identifies target areas by identifying communities’ urban, rural or highly rural designation.

– http://vaww.ruralhealth.va.gov/RURALHEALTH/docs/VA_Rural_Zip_Code_Crosswalk_Oct2012.xlsx

• VHA Support Service Center (VSSC) – This site allows researchers to locate market areas current enrollment and forecasted enrollment data.

– http://vssc.med.va.gov• ADUSH GIS Planning Portal (AGGP).

– Allows users to develop maps with drive time estimates to VA facilities. – Mapping tools show all VA medical centers and CBOCs. – Mapping does not show VA facilities that do not have their own station numbers, such as Primary Care Telehealth Outreach Clinics, vet centers, etc.

– http://vaww.pssg.med.va.gov/portal• VBA Outreach Website

– http://vaww.va.gov/NATIONALOUTREACHOFFICE/index.asp• VBA outreach coordinators

– http://vbaw.vba.va.gov/bl/27/Outreach/coordinators.htm.• Helpful policies and procedures:

– Food at Events—Follow the VA Financial Policies and Procedures Awards, Ceremonies, Food or Refreshments, Gifts or Mementos December 2010 Volume II – Chapter 4 http://www.va.gov/finance/docs/VA-FinancialPolicyVolumeIIChapter04.pdf

– Liability for space rental is covered by the Federal Tort Claims Act, (28 U.S.C. 1346(b),2671-2680).

– Policy related to surveying Veterans. Collections of Information, VA DIRECTIVE 6309, January 2010

– http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=532&FType=2.• Link to Federal Benefits for Veterans, Dependents and Survivors (available in Spanish)

– http://www.va.gov/opa/publications/benefits_book.asp.

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Timeline and Suggestions for a Community Information and Referral Workshop

3 Months Prior to Community Information and Referral Workshop:• Identify and secure training location.

– Ensure adequate handicapped accessible parking. – Ensure the location has adequate space/room size, microphone, projector, computers, comfortable seating and room to network.

– Often community partners can identify a site for the workshop that is inexpensive or at no cost. – If VA is paying for the workshop location, involve your purchase cardholder now. The space may have a “Use Agreement” that needs to be signed and the site will need to be entered into the vendor file. Your purchase cardholder will know what this entails.

• Identify and invite your presenters/subject matter experts. – Share the presentation guidelines with your presenters. They should provide a brief overview of their services and benefits and leave plenty of time for questions and discussion.

– Provide enough information to help agencies recognize the needs of their Veteran population and where VA may be able to help.

6 Weeks Prior to the Community Information and Referral Workshop:• Send workshop invitations to community members and organizations. Request an RSVP about

1 week prior to event.• If the workshop extends over the lunch hour, provide refreshments and a light lunch.• Identify vendors in the area who might provide the meal. Work with your purchase card holder

to ensure proper documentation for the food purchase for non-VA participants. • The VA has strict policies governing food purchases in place when it comes to purchasing food

and VA employees must pay for their own lunch.1 Week Prior to the Community Information and Referral Workshop:• Prepare a presentation folder for the Community partners, including the following:

– Name badges – Local Points of Contact for the closest VA Medical Center, CBOC and other VA programs – Current edition of the Federal Benefits for Veterans, Survivors and Dependents – Presenters PowerPoint handouts – Any other pertinent marketing material such as My HealtheVet pamphlet, suicide hotline number, etc.

– Notepads and pensDay of the Community Information and Referral Workshop:• Arrive at least one half hour early.• Set-up tables and chairs to promote open discussion (open circles or tables facing each other

rather than a lecture podium).• Place presentation folders on tables prior to participants’ arrival.• Allow time for breaks.• Allow time for networking.

Opening the Community Information and Referral Workshop:• Introduce yourself and your team. Talk about your background and interests. You should also

talk about why you choose to work for VA.• Talk about the Veterans in the community and why outreach is important.

– Distance from healthcare facility. – Number of currently enrolled Veterans. – Projected growth of Veterans. – Partnership potential and opportunities for success.

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Appendices• Discuss why this group was invited.

– Identified as strong community leaders with an interest in serving their community, including Veterans.

– Key to helping VA learn what resources are available in the community.• Clearly explain the goals of the workshop.

– Enables the community to learn more about resources available through VA, state, Veteran service organizations and local entities.

– Allows the VA to learn more about resources available in the community. – Creates the partnerships to plan and hold an outreach event.

• Establish the ground rules. – Focus on building our future relationship to better serve Veterans. – Be creative, have fun and work hard in event planning.

• Encourage participants to introduce themselves, their organization and missions.• Acknowledge and thank the Veterans in the group for their service.• Talk about the mission of VA. Most people do not know there are three branches of VA.

– Veterans Health Administration (VHA). – Veterans Benefits Administration (VBA). – National Cemetery Administration (NCA).

Forming a Partnership with the Community for Planning an Outreach Event:• After the formal workshop presentations have concluded, work on forming a partnership with

the attendees.• Ask the community for their help in extending the reach of VA by helping with their

participation in organizing an outreach event.• Do not restrict the number of volunteers for the planning committee. (Be prepared for members

to drop out as the planning evolves).• Brainstorm with the group to identify upcoming community events where Veteran outreach

could occur.• Remember this activity is community driven with VA being the partner, not the leader.• Do not say “no” to anything the group discusses. Instead, discuss the opportunities. Have fun

and be enthusiastic!• Ask for volunteers willing to participate in weekly planning calls for about the next 12 weeks.

– Set date and time for first call.• Follow-up quickly after the event to capitalize on the energy of the group.

Closing the Community Information and Referral Workshop:• Thank everyone for coming and remind them of the contacts in the folder.• Ask everyone to fill out a training evaluation form.• Thank the volunteers on the planning committee and restate the time and date of the first call.• Remind everyone of the reference material and contacts.• Remind the group to look out for advertising and marketing of the event once it has been

scheduled, and encourage their attendance at the event.• Be the last person to leave. This allows for the potential of more side conversations and the

formation of partnerships.

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Timeline and Suggestions for Community Veterans Outreach Event

3 months prior to the Outreach Event.• Determine what type of event will draw most Veterans. Consider

planning a special Veteran-focused event or tagging onto an existing community event, such as a health fair or job expo. In some communities, there are specific events for Veterans (e.g. Pow-wows, Stand-downs, Veteran’s Day activities or honorings). Discussion with your community partners will help guide this decision.

• Determine date and time for the event. Most of our outreach events have been held at midday on a Saturday (approximately 10 am to 2 pm). Plan the date and time of the event with your target audience in mind.

• Plan a date when the weather conditions allow for maximum participation.

• Coordinate events around the community’s schedule. In some communities, planting, harvesting, cattle round-ups, commercial fishing, or religious events may prevent many Veterans and others from attending outreach activities.

• Brainstorm vendors and exhibitors to invite. Document points of contact with addresses and phone numbers. The planning committee will determine who will reach out to exhibitors. Remember to invite local agencies to have a booth at the event so they can inform attendees about the services they offer to Veterans.

• If this is a Veteran focused event, we recommend having an emcee to welcome attendees and make announcements. Ideally, this person should be from the community. An emcee keeps the energy level high and provides direction and flow to vendors.

• Discuss marketing and communication plans. Who are the media contacts in the community? Include radio and TV for public services announcements, and articles in the local newspaper(s). Your Public Affairs Officer can help coordinate publicity activities with the community.

• Incorporate military traditions into the event, if possible (such as posting of the Colors via a Color Guard, a Chaplain’s Invocation, or a blessing from a spiritual leader or elder of a Tribal community) and identify potential participants.

• Providing light refreshments allows patrons to stay longer if the event runs over traditional lunch time. Your community partners can help identify local groups that might provide refreshments.

• Consider local laws regarding food handler’s permits, taxes, etc.• In many RVO sites, the community wanted to hold a door prize

drawing. In some sites, community partners solicited donated door prizes from local businesses. At one site, VA Medical Center employees donated items they crafted for the door prizes. Giving door prizes throughout the day helps keep the energy up during the event.

Some Veterans may have

trouble with large crowds and loud noises and

may not feel comfortable in events open to the public with large crowds or 4th of July

activities.

Older Veterans may prefer a

daytime event in the middle when traffic is lighter

and it is safer to drive. Evening or weekend events

may better accommodate

a single working mother or college

student who is a Veteran.

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AppendicesWhen identifying potential venues, consider the following:

• Centrally located such as a facility on the main street of town.• Post signs to promote the event in clear view of the main

traffic areas.• Climate controlled, if possible.• Have access to Wi-Fi/Internet, if possible.• Consider the electrical power needs of the vendors.• If there is a charge for the venue, identify contract terms and

determine how this will be funded. • Parking should be handicapped accessible with adequate lighting.• Create spaces for privacy. Privacy areas allow the vendor and

patron to talk about sensitive information without being overheard.

• Provide an area for patrons to sit, socialize and eat.• When determining where to place booths, consider placing

agencies with similar missions together. • Provide enough room around the vendor tables for the

vendor to walk around the table, for people to gather, and for wheelchair accessibility.

– Consider providing VHA and VBA booths with extra space and seating to accommodate larger numbers of Veterans attempting to enroll.

• Provide attendees and vendors with a map of the venue.Vendors and Exhibitors

• Identify vendors.• Obtain vendors’ mission statements and how vendors will

help Veterans.• Identify vendors’ needs (space, power source, tables, and chairs).

At one event, the Daughters

of the American Revolution provided

refreshments free of charge. At

another event, a university

student club sold food items to raise money for a study abroad trip.

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6 weeks prior to the outreach event.Marketing and Media

• A VA Public Affairs Officer (PAO) should be included to work with community partners and local media to promote the outreach event.

• Print announcements – Write a brief media announcement that can be published or broadcast. In addition to local and regional newspapers, the community will help you identify other outlets for promoting the event:

� Church newsletters and bulletin boards � Local governments websites � Civic organizations and Veterans Service Organizations newsletters � Posters and flyers in local hangouts (e.g., cafés, grocery stores, etc.)

• Television and radio. – The VA PAO can help develop a public services announcement and marketing plan. – Invite local TV stations to cover the event and ask them to help promote it. Remember, stations in larger markets also cover rural areas and will often feature stories about how local communities are serving Veterans.

– Rural radio stations broadcast to a large area and often are looking for stories. – Say yes to interviews!

• Direct mailing. – Many community agencies already maintain a list of local Veterans that have used their services. Invite these agencies to mail the public service announcement and invitation to the event to the Veterans on their list. These lists should not be shared outside the agency to protect Veterans’ privacy.

• Digital media. – Encourage the VA facility to promote the event on their website and other digital media services.

– Work with community partners to identify local email groups, websites and other digital media services where the event can be promoted.

The Day Before the Outreach Event• Meet with your community partners to go over last minute details. By the time this event

occurs, all of you will have a great feeling of collegiality and value the relationship.• Preparing the venue:

– With your community partners, meet with facility management to assure all requirements are met.

– Set up tables and chairs. – Bring a few tools to assist with set up: hammer, scissors, screwdrivers, duct tape, markers and pens.

– Populate your floor plan with location of vendors/exhibitors so that you can direct them on the morning of the event.

– If possible, assist vendors with set up and power. – Review the floor plan to ensure enough space for attendees to move among the booths.

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AppendicesThe Day of the Outreach Event• Arrive early to address any last minute issues. We usually arrive

about 3 hours early. • Assure vendors/exhibitors are directed to their table/area and assist

them in setting up, if needed.• Set up a greeting table with a community partner, preferably a

Veteran, stationed in this area throughout the event.• Set up a table close to the exit for communities to request Veterans’

comments about whether the event met their needs and how to improve future events.

• The PAO can coordinate photos and videos of the event. Veterans that appear in photos or videos that are publicly posted should complete VA Form 10-3203.

• Have fun! This is a positive experience for you and for all involved to serve our Veterans!

After the Event• Have a wrap-up call with your planning committee within two

weeks of the event to discuss: – Lessons learned – Areas of success – Areas for improvement – Next steps for addressing future Veterans’ issues

• Distribute a final report containing your data collection and the lessons learned to planning group partners.

Many Veterans may arrive

very early. Be prepared to

greet them with information.

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